Scottish Daily Mail

Is exercise making my heart beat too fast?

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I DO a weekly boxercise class, wearing a heart rate monitor. I am 61 and for short periods I hit a peak heart rate of 202 beats per minute — I’ve read that my maximum should be 160.

My average heart rate during the class is 155 and, at the start, it’s 100. I don’t feel unwell, but should I stop boxercise? Seven years ago I had a brain haemorrhag­e when lifting weights. Could it be linked?

Apeak heart rate of more than 200 beats per minute is, I agree, considerab­ly higher than I’d expect in a man of 61, especially as you’re likely to be reasonably fit after some years of weekly exercise.

I am also concerned to hear that your resting heart rate is around 100 beats per minute — which again is faster than normal in a healthy individual your age. I’d hope to see a level between 60 and 70.

Heart rate monitors such as the one you’ve been using allow you to track your performanc­e and monitor your fitness levels over time — not only does this help you stay motivated to exercise, but it may also give an indication of potential problems with your health.

although there is no inherent danger from a raised heart rate itself, it is important to establish whether there is an underlying problem or condition that is causing it.

You’ve not mentioned any medication you’re taking, but typically after a brain haemorrhag­e — a type of stroke caused by a burst blood vessel — patients are given treatment to lower blood pressure (hypertensi­on is a common risk factor for stroke). some blood pressure drugs, nicardipin­e, for example, can cause an increase in heart rate, known as a reflex tachycardi­a.

BName and address supplied. esIdes medication, another common cause is an overactive thryoid — where the thyroid gland spontaneou­sly starts to secrete excess thyroid hormones, which in turn cause the metabolism to speed up, affecting heart rate.

In my view, your increased heart rate should be investigat­ed further; this means discussing your symptoms with your Gp.

You may be offered a blood test to check your thyroid function. Your doctor will probably also refer you for an exercise electrocar­diogram to record your heart’s electrical activity while you’re exercising on a treadmill. You’ll be encouraged to push your heart rate up to its maximum in a controlled environmen­t, and the test will help show whether there’s anything abnormal about your heart’s function when under stress from physical activity.

Your brain haemorrhag­e seven years ago is unlikely to be responsibl­e for your rapid heart rate now. There will be another cause, so I’d urge you to look into it further and refrain from pushing yourself to maximum levels at the moment. Take it a little easier until you know more. ONCE a month I suffer from attacks of pressure in my right ear, followed by severe dizziness. They last two to three minutes. My GP said it sounded like labyrinthi­tis and referred me to an ENT clinic, where I had a hearing test, with above average results. The specialist said the attacks would stop, but they haven’t. Can you help? I’m 26. Russell Beint, Swindon.

Your dizziness sounds like vertigo — the sensation that you or the environmen­t around you is spinning. Vertigo is usually related to a disorder of the balance mechanism, the part of the inner ear often called the labyrinth. The term ‘labyrinthi­tis’ is simply another way to describe a problem with the labyrinth. It does not tell us the cause.

It seems the key points in your case are that the episodes are brief and preceded by a sense of pressure in the ear, but that your hearing is normal.

Therefore I think it’s unlikely to be Meniere’s disease (where a build-up of fluid increases pressure in the labyrinth). Here, there are bouts of vertigo, but these last for hours or days, rather than minutes. patients may also have tinnitus (ringing, hissing or buzzing in the ears) and hearing loss.

I’d also rule out viral labyrinthi­tis, a viral infection of the inner ear. Here, the vertigo is usually continuous for five to ten days, rather than a pattern of brief but repeating episodes.

It’s also unlikely to be benign paroxysmal positional vertigo, which occurs as a result of crystals building up in the ear canals. This causes brief episodes of vertigo, triggered by moving the head and is eased by remaining still. I suggest the most likely diagnosis is vestibular migraine (the vestibular mechanism is another word for the labyrinth). This refers to bouts of vertigo in patients who typically — but not always — have a history of migraine headaches.

HeadacHes don’t occur during the attack itself, though there may be pressure — or fullness — in the ear on one side. Because your episodes are so brief, there is little point taking a tablet to treat migraine, such as sumatripta­n. a daily migraine prevention tablet (the drug topiramate, originally developed to prevent seizures in epilepsy, is sometimes used for this purpose) would also be unsuitable.

I believe it will eventually clear up. perhaps in the meantime you should avoid driving, cycling and other activities which could be dangerous during an attack.

You should also keep a diary of attacks to identify any triggers.

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